Active NPI
Gerald Loftus III
- Behavior Technician
- Middleboro, MA
National Provider Identifier
1679019764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- S22730577
- Practice address
- 25 Wareham St
Middleboro, MA 02346-2456 - Phone
- (508) 465-0417
- Fax
- (508) 465-0793
- NPI assigned
- Jan 12, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | S22730577 | MA | |
| Behavior Technician | 106S00000X | S22730577 | MA | Primary |
Addresses
Primary practice location
25 Wareham St
Middleboro, MA 02346-2456
Mailing address
25 Wareham St
Middleboro, MA 02346-2456
Phone (508) 465-0417
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S22730577 | MA | MD | Assistant Behavior Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484265600000",
"number": "1679019764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 WAREHAM ST",
"city": "MIDDLEBORO",
"state": "MA",
"postal_code": "023462456",
"telephone_number": "508-465-0417",
"fax_number": "508-465-0793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 WAREHAM ST",
"city": "MIDDLEBORO",
"state": "MA",
"postal_code": "023462456",
"telephone_number": "508-465-0417",
"fax_number": "508-465-0793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOFTUS",
"first_name": "GERALD",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-12",
"last_updated": "2017-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "MA",
"license": "S22730577",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MA",
"license": "S22730577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middleboro, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.